CAJ | 학술논문

目的探讨创伤性膈肌破裂术前诊断及手术入路,以期提高患者的术后生活质量.方法回顾性分析1990年1月至2009年3月收治的63例创伤性膈肌破裂患者的临床资料.所有患者均经手术证实为膈肌破裂,均有不同程度的血胸和/或血气胸.急性腹膜炎49例,失血性休克41例.术前诊断明确37例,术中探查发现22例,4例经保守治疗无效后行手术治疗.单纯经胸入路24例,单纯经腹入路14例,胸腹联合入路8例,经胸经腹分别入路17例.结果 57例痊愈,死亡6例,其中2例死于失血性休克,1例死于心包填塞,1例死于术后呼吸衰竭,2例于术后1周死于肾衰竭.结论术前诊断的准确及时和正确的手术入路选择是争取抢救时间、抢救成功与否、避免并发症的关键.
목적 탐토창상성격기파렬술전진단급수술입로,이기제고환자적술후생활질량.방법 회고성분석1990년1월지2009년3월수치적63례창상성격기파렬환자적림상자료.소유환자균경수술증실위격기파렬,균유불동정도적혈흉화/혹혈기흉.급성복막염49례,실혈성휴극41례.술전진단명학37례,술중탐사발현22례,4례경보수치료무효후행수술치료.단순경흉입로24례,단순경복입로14례,흉복연합입로8례,경흉경복분별입로17례.결과 57례전유,사망6례,기중2례사우실혈성휴극,1례사우심포전새,1례사우술후호흡쇠갈,2례우술후1주사우신쇠갈.결론 술전진단적준학급시화정학적수술입로선택시쟁취창구시간、창구성공여부、피면병발증적관건.
Objective To study preoperative diagnosis and operative route of traumatic diaphragmatic rupture in order to improve postoperative quality of patients' life.Methods A retrospective analysis was carried out in 63 patients with traumatic diaphragmatic rupture,all that were identified through operation from January 1990 to March 2009.All cases were associated with pneumothorax and/or hemopneumothorax at various degrees.Forty-nine cases complicated with acute peritonitis and 41 cases complicated with hemorrhagic shock.Thirty-seven cases were diagnosed definitely preoperatively,22 cases were found in operations research,4 cases with inefficacious conservation converted to operation.Thoracotomy was performedin 24 cases,laparotomy in 14 cases,combined thoracolaparotomy in 8 cases and thoracotomy plus laparotomy in 17 cases.Results Fifty-seven cases recovered,6 cases died of hemorrhagic shock (2 cases),pericardial tamponade ( 1 case),acute respiratory failure ( 1 case) and acute renal failure at postoperative 1 week (2 cases).Conclusion Definite and timely preoperative diagnosis and correct operative approach are striving the rescue time and success and avoiding complication.